| NPI | 1740688142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA JORDAN Dentist/Owner 404-243-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012645) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |